ATI RN
Ethical Issues in Maternal Newborn Nursing Questions
Question 1 of 5
Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?
Correct Answer: C
Rationale: In the immediate postpartum period of a breastfeeding woman, the hormone that remains elevated is prolactin. Prolactin is responsible for stimulating milk production in the mammary glands, thus supporting breastfeeding. This hormone plays a crucial role in establishing and maintaining lactation to meet the newborn's nutritional needs. Estrogen and progesterone levels decrease significantly after childbirth. Estrogen levels drop due to the expulsion of the placenta, and progesterone decreases as the corpus luteum regresses. These hormonal changes help prepare the body for lactation and the resumption of the menstrual cycle. Human placental lactogen (HPL) is a hormone produced by the placenta during pregnancy to facilitate fetal growth and development. Its levels decrease rapidly after delivery since the placenta is expelled during childbirth. Understanding the hormonal changes in the postpartum period is vital for maternal newborn nurses to provide optimal care to breastfeeding mothers and newborns. By knowing which hormone remains elevated and its role in lactation, nurses can support and educate new mothers on successful breastfeeding practices.
Question 2 of 5
The nurse should be cognizant of which postpartum physiologic alteration?
Correct Answer: B
Rationale: In maternal newborn nursing, understanding postpartum physiologic alterations is crucial for providing optimal care to mothers. The correct answer is option B: Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth. This is an essential physiological change to monitor as it impacts the overall health and well-being of the mother. Option A is incorrect because cardiac output, pulse rate, and stroke volume may take longer than 48 hours to return to prepregnancy normal values. Option C is incorrect as a lowered white blood cell count after pregnancy does not typically lead to false-positive results on tests for infections. Option D is incorrect because although a hypercoagulable state is present postpartum, it does not necessarily protect the mother from thromboembolism, especially after a cesarean birth. Educationally, understanding these postpartum physiologic alterations prepares nurses to recognize and respond to potential complications in the postpartum period. Monitoring respiratory function is vital for detecting any abnormalities early on and ensuring the mother's well-being. Nurses need to be knowledgeable about these changes to provide evidence-based care and promote positive outcomes for both the mother and newborn.
Question 3 of 5
The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge, called lochiWhich statement is the most appropriate?
Correct Answer: D
Rationale: The correct answer is D: "It should smell like normal menstrual flow unless an infection is present." This statement is most appropriate because it accurately reflects the expected odor of lochia, which is typically described as similar to a normal menstrual flow unless an infection is present. This information is crucial for the client to monitor their postpartum recovery for signs of infection, such as foul-smelling discharge. Option A is incorrect because lochia is typically heavier and more prolonged than a light menstrual period in the immediate postpartum period. Option B is incorrect as the amount of lochia is not necessarily greater after cesarean births compared to vaginal deliveries. Option C is incorrect as while ambulation and breastfeeding can help with uterine involution and reduce bleeding, they do not directly impact the amount of lochia. In an educational context, understanding postpartum discharge is essential for maternal newborn nurses to educate clients on normal postpartum changes, signs of complications, and the importance of seeking medical attention if any abnormalities are noted. Proper education on lochia can empower clients to monitor their health effectively during the postpartum period.
Question 4 of 5
Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process?
Correct Answer: C
Rationale: In maternal newborn nursing, understanding the normal postpartum involution process is crucial for providing appropriate care. Option C, "Fundus below the symphysis and nonpalpable," indicates a normal involution process on postpartum day 14. This finding suggests that the uterus has involuted to its pre-pregnancy size and is descending back into the pelvis, which is expected at this stage postpartum. Options A, B, and D are incorrect. Option A, "Moderate bright red lochial flow," may indicate a normal lochial discharge, but it does not specifically reflect the involution process of the uterus. Option B, "Breasts firm and tender," pertains to breast changes related to lactation and not uterine involution. Option D, "Episiotomy slightly red and puffy," focuses on the healing process of an episiotomy site and is not directly related to uterine involution. Educationally, it is essential for nurses to accurately interpret and document postpartum assessments to monitor the mother's recovery effectively. Understanding the significance of specific findings, such as the position of the fundus, helps in identifying deviations from normal and initiating timely interventions. This knowledge ensures optimal postpartum care and promotes maternal well-being.
Question 5 of 5
A nurse is caring for a client who is receiving oxytocin to augment labor. The client has an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring. Which of the following is an indication that the nurse should discontinue the infusion?
Correct Answer: B
Rationale: In this scenario, option B, "Contraction duration of 100 seconds," is the correct answer that indicates the nurse should discontinue the oxytocin infusion. Prolonged contractions can lead to uteroplacental insufficiency, compromising fetal oxygenation and perfusion. This can result in fetal distress and hypoxia, necessitating urgent intervention. Option A, "Contraction frequency every 3 min," is within the normal range for labor progression. Optimal contraction frequency is typically every 2-3 minutes in active labor. Option C, "Fetal heart rate with moderate variability," is a reassuring sign of fetal well-being. Moderate variability indicates a healthy autonomic nervous system and adequate oxygenation to the fetus. Option D, "Fetal heart rate of 118/min," is within the normal range for a fetal heart rate. A normal fetal heart rate typically ranges from 110 to 160 beats per minute. In an educational context, understanding the significance of monitoring parameters during labor is crucial for nurses providing care to laboring women. Recognizing abnormal patterns and knowing when to intervene is essential to ensure optimal outcomes for both the mother and the baby. Regular assessment and vigilance are key in maternal newborn nursing to promote safe and effective care.